The program list from the recent AAD meeting in Florida gives an idea of where Galderma are concentrating their promotional efforts.

Let us start with the list of advertisers ;

You can see that Galderma is far and away the most prominent advertiser.

Many won’t have seen these advertisements, so here we are, a snapshot of the sorts of marketing material that Galderma is using to target practitioners. In the handouts each prescription product is normally accompanied by a second page comprising the mandatory prescribing information.

Click on the images for a bigger version.

Oracea

Oracea is promoted as a `direction’ that is a `Power Change for the Journey Ahead’. The advertisement is highlighting the low incidence of side effects, a similar efficacy to 100mg doxycycline and a reduction in lesions in as little as 4 weeks. Using words like journey and `better tomorrow’ and mentioning that no side effects were seen in 9 months suggests that Oracea is seen as a long term prescription.

Oracea has been earned marketing awards in the past. In September 2009 we learnt that Oracea is worth $104m a year.

Metrogel 1%

Tagline: In the world of rosacea sufferers, it all comes back to the one.

When the patent on Metrogel expired, other companies have been free to market their own generic metronidazole. Galderma then launched a modified version of metrogel, increasing the concentration of metronidazole from 0.75% to 1%. The formulation was `enhanced with HSA-3 and niacinamide. HSA-3 is described as a combination of ingredients including betadex, niacinamide (vitamin B3), and propylene glycol.”

Cetaphil

Tagline: Essential for a balanced diet for healthy skin. and Every Body Benefits.

Galderma here are promoting what it sees as a non-irritating cleanser, fragrance-free moisturizer, being non-greasy and non-comedogenic and being ideal for face, hands and body.

Sponsorships

Galderma is one of the major sponsors of the National Rosacea Society. You can see from the  NRS web site, Galderma’s donations enable the NRS to conduct their educational program.

Other Products

Of course Galderma is also developing a product dubbed sansrosa, it calls CD07805/47. If and when this product comes to market, Galderma’s rosacea portfolio will be even more impressive.

So What ?

OK so this is all interesting, but what would you like to see from Galderma ? How would you like to see the deepest pockets in the industry spend their research, development and promotional dollars ?

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• Oracea to replace Periostat, new rosacea treatment launched

A recent article from ABC7 featuring a skin analysis tool called VISIA Complexion Analysis System. The article suggests that the system uses multiple measures, including a porphyrin count to predict how likely a person is to get acne or rosacea. The system also gives a measure of the `skin age’ of an individual.

The VISIA Complexion Analysis web site lists the six key factors assessed as

• wrinkle
• spots
• pore size
• skin tone variations
• bacterial content
• UV spots that indicate sun damage

It would be interesting to see whether there is any research available linking the prevalence of porphyrin and the incidence of rosacea. It might be possible that sun damage is linked to rosacea in some individuals so this tool could have some use. It is a nice idea to be able to predict if someone is likely to develop rosacea, but I do have to wonder if such a tool could be as simple as the one featured here.

As a related noted, a rare but painful disease  known as Erythropoietic Protoporphyria (EPP) is caused by a build up of protoporphyrin in the skin. Exposure to the sun causes these molecules to be phototoxic.

The VISIA skin analysis consultation is free, with doctors hoping to offer you treatments like dermal fillers or laser treatments to reduce the visible signs of skin ageing.

The related video ends with advice to cover up outside, wear sunscreen etc. This is good advice even if you aren’t worried about your apparent skin age getting ahead of your real age.

New system shows your skin’s true age

Monday, March 01, 2010

BEVERLY HILLS, Calif. (KABC) — With every birthday, you become all too aware of your chronological age. But your skin age might have a different number. Is your skin aging prematurely? Take a look at a machine that helps doctors predict what the future holds for your face.

…

"This type of machine shows us a lot more detailed specifications of aging," said Dr. Ourian. "I can find out if a person’s pores are getting to be too large, which actually shows me if their skin is losing its elasticity."

It’s called the VISIA Complexion Analysis System, and it sees the beginnings of fine wrinkles, UV-ray damage and discoloration. It takes a porphyrin count to predict how likely a person is to get acne or rosacea.

Related Articles

• Suffering as bad as it gets; Erythropoietic Protoporphyria
• Phototherapy: a guide to the pitfalls of terminology
• rosacea, red light (acne lamp), clonidine and noritate

Dr. Nielson became known to rosacea sufferers via the way that his Rosacea Institute of Texas was heavily promoted by Geoffrey Nase. The results being promised and the treatment protocols proposed raised the suspicion of some rosacea sufferers. Now, a few years later we can all see that the partnership between Nielson and Nase was indeed based on unsustainable promises and poor medicine.

Medical Board Disciplines 70 Doctors and Issues 671 Licenses

FOR IMMEDIATE RELEASE
Wednesday, February 17, 2010

Nielson, David Hugh, M.D., Lic. #K0962, San Antonio TX

On February 5, 2010, the Board and Dr. Nielson entered into an agreed order requiring Dr. Nielson to complete 15 hours of CME in medical record-keeping, risk management and ethics within one year; and pay an administrative penalty of $4,000 within 60 days.

The action was based on the Board’s finding that Dr. Nielson

• failed to keep adequate medical records
• failed to use proper diligence in his professional practice, and
• failed to adequately supervise the activities of those acting under his supervision.

The Board found that digital photos that were part of patient records were inadvertently deleted and that Dr. Nielson authorized a person to represent his clinic and that person misrepresented risks and procedures for Dr. Nielson’s treatment of rosacea.

The full disciplinary notice is available publicly and offers further statements detailing the reason that Nielson has been ordered to pay a penalty and undertake extra education. More specifically the medical board made the following findings with respect to the partnership between Nielson and Nase.

• Nase was heavily involved in treatment plans, even though not present, with the care and treatment of patients at the Rosacea Treatment Institute of Texas.
• Nase conducted telephoned and email consultations, on Nielson’s behalf and under Nielson’s authority.
• Nase misrepresented risks and procedures for the treatment of rosacea generally, comparative risks related to Nielson’s treatments, the professional superiority of Nielson’s treatment procedures and optimistic outcome of Nielson’s treatments citing minimal side effects, long-lasting improvement and in some cases, even permanent improvement.

I think the rosacea community is well within its rights to feel especially aggrieved about this last finding. Rosacea sufferers, especially those desperate for relief deserve better than being preyed on by unscrupulous practitioners.

This order comes just a few days after we learned that Dr. Syed had been charged for posing as a doctor.

I wish I could offer better advice than the obvious statement that if something sounds too good to be true then it probably is.

Be careful out there.

Related Articles

• Dr. Syed charged for posing as a doctor
• Rosacea Guru to end battle over critic’s site
• Debunking Dr. Geoffrey Nase

The whole idea of natural treatments is very appealing to many rosacea sufferers. There is certainly a group of rosacea sufferers who see prescription treatments as too artificial and too likely to cause harm. As it almost always the case in matters medical, the equation is not actually that simple.

The potential for many naturally-sourced treatments to cause harm is as real as for prescription treatments.

One could even make the argument that prescription treatments have well known side effect profiles whereas the unknown reactions of natural remedies can expose rosacea sufferers to unnecessary risks.

Additionally the quality control procedures for prescription treatments ensure that users can be confident in the accuracy and authenticity of ingredients.

Do you personally believe that natural treatments pose risks to you as rosacea sufferer ?

‘Natural’ remedies can prove lethal: research

NICK MILLER

February 9, 2010

SOME popular herbal medicines can be dangerous, even lethal, contrary to the perception that they are a safe alternative to conventional medicine, a University of Adelaide researcher has warned.

Naturopaths agree that there are dangers in herbal medicines for people who self-diagnose and then ”treat” themselves with off-the-shelf products. However, they say the industry is generally well regulated.

Forensic pathologist Roger Byard reviewed the risks attached to herbal medicines in last month’s edition of the Journal of Forensic Sciences.

He said herbal products had been found to contain potentially lethal levels of arsenic, mercury or lead. Even if not contaminated, some herbs posed health risks such as liver failure, haemorrhage or heart failure.

…

‘People think, ‘It’s growing in the garden – green is good’ but plutonium is natural, too,” Professor Byard said. ”Part of the problem is herbs are very hard to test for [during an autopsy]. We just don’t know if this is a widespread problem, we don’t routinely test for them.”

…

In his paper, Professor Byard wrote that a recent analysis of 251 Asian herbal products sold in California had found arsenic in 36, mercury in 35 and lead in 24. There were several cases of young children developing lead or arsenic poisoning from traditional remedies.

Popular remedies such as ginkgo biloba, pennyroyal and ma huang can cause liver damage if overused, and a wide range of herbs can trigger heart problems.

Related Articles

• Treating Rosacea with Herbs
• NYTimes says no natural treatments for rosacea
• AAD: natural ingredients have a role in rosacea therapy
• do naturopathic or homeopathic treatments work for rosacea ?
• natural anti-inflammatory therapies

Quite a few news sites today are covering the filing of charges of and arraignment of rosacea identity “Dr. Syed”.

Known to rosacea sufferers as Tanweer A. Syed MD. PhD, 66 year old Timothy Syed Andersson is facing 51 felony charges including practicing medicine without a license, grand theft by deception and perjury.

Andersson has been found to have no formal training or license in the United States or abroad.

His web site has impressive sounding terminology such as “professional expertise in the field of extracting and synthesizing natural bioactive” and “incorporating biologically active natural ingredients into skin cream emulsions”, as well as “patent pending proprietary formulation” and also “powerful antioxidant is truly bio-available”.

Rosacea News has covered Dr. Syed and his products in the past. He was well known to rosacea sufferers for his very expensive Green Tea based cream. His cream was in fact found to contain hydrocortisone. The District Attorney Kamala Harris was quoted as saying the green tea cream was “a bunch of BS”. Users of his cream were found to be located all over the United States as well as several overseas countries.

Andersson has cleverly promoted his cream as appealing to rosacea sufferers. In 2007 he was listed as a member of the RRDi Medical Advisory Committee. His $125 Hypo-Allergenic Facial Cream (supposedly green tea  based) was not well received by rosacea sufferers as you can see in a few forum postings.

Be Careful out There

The charging of Andersson on serious charges is a great opportunity for rosacea sufferers to step back and think about what they read and accept and who they trust. Especially online, we all need to watch out for people who call themselves a doctor and have a web site full of gobbledegook.

Don’t trust someone who is not a licensed M.D. to offer you a consultation. Don’t buy products that promise results that appear suspicious.

Andersson has claimed to investigators that he does not practice medicine and just sells his facial cream from his home.

The District Attorney urges everyone to check the official registration of medical doctors and to not visit Andersson/Syed’s web site.

Related Articles

• Nielson disciplined over Nase’s misrepresentations

On the table you can see Oracea, Metrogel and Cetaphil products, all from Galderma. One shot shows the new Cetaphil UVA/UVB Defence SPF 50 as well as Daily Advance Ultra Hydrating Lotion and the well known Cetaphil Gentle Skin Cleanser.

Apparently rosacea is called `the great disguiser’, not a term I have ever heard before, but obviously refers to the long list of possible differential diagnosis for rosacea symptoms.

The NRS supplied the familiar looking rosacea symptoms photos. This amount of detail given in the story is fantastic for the medium of broadcast television. Dr. Day touched on the confusion with adult acne and the reason we get rosacea as well as possible triggers.

Oracea gets a good plug for its low dose properties. Galderma will be very pleased indeed.

Finacea and Noritate also get a mention.

Other over the counter products on the table included

• Ageless Intensives Smooth Repair Control Deep Wrinkle Anti-Wrinkle Serum from Neutrogena (what a mouthful)
• Dopti Calm Anti-Fatigue and Diopti Anti-Wrinkle from Lierac
• Lipikar Baume Anti-Irritant Lipid Replenishing Body Balm from La Roche-Posay

Galderma’s `consumer promotional’ web site bestfaceforward.com as well the NRS’s rosacea.org get a mention at the end of the piece.

It was a well thought out and informative article. This is excellent for rosacea sufferers – such high quality information in the broadcast media.

Watch the full video here ;

http://abcnews.go.com/video/playerIndex?id=9626641

Featured Product

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Author: Frank C. Powell
Review Date: December 2009
Available at Amazon.com

Some Background

First some background on Prof. Powell. Rosacea News has in the past published 3 articles that feature publications from Powell; rosacea sufferers less interested in alternative medicine, demodex mite bacteria causes the inflammation ? and rosacea: its all in the follicles !

Powell has been a consultant dermatologist at the Mater Private Hospital in Dublin, Ireland for 25 years. He has received rosacea research grants from the NRS, has been on the Medical Advisory Board of the NRS since 2000 and was also a co-author of the ground-breaking Standard Classification of Rosacea and the companion Standard Granding System for Rosacea.

Powell has an impressive list of peer reviewed publications: 18 chapters on Dermatology and related medical subjects, 18 Letters to the Editor and 98 publications in Medical and Dermatology journals. Additionally Powell is a reviewer for the Journal American Academy of Dermatology, Archives of Dermatology, British Journal of Dermatology and several others.

Even a cursory glance on PubMed shows dozens of papers published with several on rosacea.

How the book feels

My first thought when I first received my review copy, `wow it is small, it fits in my hand’.

The book is hardcover and consists of 140 gorgeous glossy pages. The high resolution colour photographs are crisp and detailed.

One thing I really liked about the book is that all of the photographs (around 64 of them) are all of Dr. Powell’s patients. This helps consolidate the authority of the text. These are real, genuine photographs of actual patients under the care of the book’s author. What an awesome body of clinical experience we can tap – simply by having access to this book.

As you will appreciate, this book must have been many years in the making.

The book also features a dozen wonderful drawings of rosacea from medical publications that existed before photographs were common. This gives us a good glimpse into how long people have been suffering from rosacea ! The cover of the book features an elegant 19th century gentleman with the erythema, papules and pustules of rosacea clearly visible.

Who is the book for ?

Dr. Powell targets the book at clinicians – `consisting of an overview of the subtypes, differential diagnosis with a practical approach to current therapeutic modalities’. We are told that the book intends to fill the gap that textbooks leave when devising solutions for individual patients. This is something that the book does well, it is not a dry medical text book steeped in theory, but also not a rambling collection of disjointed self-help styled thoughts.

We are also told that the 1993 book Acne & Rosacea by Plewig & Kligman is still the preferred authorative medical reference for rosacea. This is a bit of a shame because this book is out of print. You may be able to find a copy in your library, or you can also sometimes purchase a second hand copy via Amazon.com.

Powell thanks the Photographic Department of the Mater Misericordiae University Hospital in Dublin and also acknowledges Dr. Jonathan Wilkin’s help especially in the chapters on Flushing and `General Considerations’.

Lets look briefly at each chapter.

Chapter 1: Structure, Function, Type, and Sensitivity of Skin [14 pages]

Chapter 1 contains a description of skin structure, looking at the surface film, and the horny, granular, squamous and basal layers as well as meibomian glands, vascular plexuses and lymphatics. It concludes with a description of skin function, skin type and skin sensitivity.

Chapter 2: Flushing and Blushing [18 pages]

After defining the broad differences between flushing and blushing the book includes a detailed description of other conditions that may also cause flushing. Powell suggests that a detailed patient consultation is required to rule out other possible reasons for flushing. Powell suggests psychotherapy and cognitive behavior therapy may help desensitize social blushing and some patients may benefit from low dose beta-blockers. A table suggests other treatment options such as alpha-blockers, HRT, surgery and laser.

It was encouraging to see a mention of topical oxymetazoline with a refence to a 2007 paper. Even more encouraging is the mention of herbal possibilities like red clover, soy isoflavones, vitamin E, black cohosh and even acupuncture. Whilst the author cannot find conclusive studies in support of these supplementary therapies, it is great to see them at least given a mention.

Powell notes that even though there has been intense debate about the link between frequent facial flushing and the development of rosacea, the evidence is lacking. Prospective studies are required to unearth any link to the redness and blood vessels of rosacea, but those studies will be very difficult to execute. One patient note mentions a young man who suffered from a flushed face becoming anxious after viewing pictures of rhinophyma on the internet.

Suggested further reading includes a text from 1839 – seriously ! The Physiology or Mechanism of Blushing.

Chapter 3: The Classification and Grading of Severity of Rosacea [10 pages]

We learn in Chapter 3 that rosacea was first described in detail in 1813 by a former colleague of the English dermatologist Robert Willan. Willan was the first to call it acne rosacea. In those very early days rosacea was considered closely related to acne, perhaps sharing the same pathogenesis. As long ago as the early 20th century Radcliff-Crocker was proposing to drop acne from the name, postulating that rosacea was due to hyperreactivity of the facial blood vessels manifested by frequent flushing. Powell notes that the development of the classification of rosacea in 2002 was the first time that a widely accepted definition of rosacea was available since Willan in the early 1800s. The grading of severity of rosacea was then undertaken as a broad way of analysing the disease state and treatment progress.

Powell modestly drops his name from author listing when citing the Standard classification of rosacea and Standard grading system for rosacea at the end of this chapter.

Chapter 4: Erythematotelangiectatic Rosacea (Subtype 1) [17 pages]

A persistent facial redness, a tendency to frequent flushing, presence of multiple fixed dilated small blood vessels leads to the diagnosis of Erythematotelangiectatic Rosacea (ETTR).

A clinical example was offered for a classical case of ETTR, but also for someone diagnosed with the similar looking condition Heliodermatitis (chronic photodamage). Some clinicians use the terms ETTR and Heliodermatitis interchangeably as they appear similar and often respond to the same treatments. In this case the patient, a farmer, did not respond to metrogel or doxycycline so was told to use a sunscreen all year round and offered IPL.

An in interesting quote ;

Even though ETTR is classified as subtype 1 rosacea, this is not intended to suggest that it represents the first stage in the progressive development of the other subtypes of rosacea and many patients do not subsequently develop other manifestations of rosacea. The inflammatory papules and pustules of stage 2 (papulopustular) rosacea (PPR) do not develop as a consequence of the erythema and telangiecstasias in subtype 1 disease.

…

Typically the erythema associated with PPR is secondary to inflammatory changes in the skin rather than the presence of telangiectatic vessels.

We are told that the most important condition to rule out when diagnosis ETTR is systemic lupus erythematosus (SLE).

Treatments for ETTR include the usual suspects, but Powell does mention physical sunscreens containing Titanium Dixoide and Zinc Oxide and a moisturizer. Mention is also made of topical oxymetazoline as a recent possibility.

Chapter 5: Papulopustular Rosacea (Subtype 2) [30 pages]

One line appealed to me when describing PPR “New lesions appear as the older ones fade if effective treatment is not instituted”. This was so me ! I would look each morning to see where I was going to get the next red lump or pussy bump, having just seen on the current batch.

Powell mentions that it is possible for sufferers of male pattern baldness to have papulo pustular rosacea on their scalp. This is the first time I have read this.

A page is devoted to the the possible involvement of demodex mites in rosacea. Powell says that it is probably impossible to fully eradicate the mites from our skin as they see to recolonize rapidly following anti-mite therapy. Powell notes that some of the demodex related bacteria are susceptible to the antibiotics used to treat the papules and pustules of rosacea, perhaps suggesting a reason for the effectiveness of topical and systemic antibiotics in the management of rosacea.

Indeed the cause of rosacea is unknown so Powell also mentions the possible involvement of antimicrobial peptides, Vitamin D and sunlight as two interesting areas of research.

This chapter contains an excellent list of photographs and clinical notes for the several alternative diagnoses that may mimic papulopustular rosacea.

The therapy section contains all the well know topical and systemic therapies for the papules and pustules of rosacea.

Some treatments that caught my eye were Oxymetazolinea, Permethrin and Ivermectin. Yes it does indeed appear that demodex mite treatments are becoming mainstream for rosacea sufferers. Typically topical permethrin and systemic and topical ivermectin are used for mite infestation. Powell does note though that the use of these therapies is currently unproven.

A nice feature is the Algorithm management of PPR – a flow diagram on how to manage patients who present with PPR.

Chapter 6: Phymatous Rosacea (Subtype 3) [18 pages]

We are told that Rhinophyma is fortunately rare and often the most visible form of rosacea. It was first describe in the medical literature in 1845. Powell suggests that rhinophyma is more accurately designated as a condition of the skin that is closely associated with rosacea rather than a disorder that occurs as a consequence of the disease.

I wasn’t aware that there are actually several types of rhinophyma: glandular, angiomatous, actinic, acneform, fibrous and obstructive.

The management section details the use of isotretinoin for early stage glandular rhinophyma. Powell notes that there are conflicting reports about it’s efficacy, optimum dosage and long term outcomes. Dapsone  is also mentioned. The Pulse Dye and CO2 lasers are mentioned as possible treatments.

Chapter 7: Ocular Rosacea (Subtype 4) [14 pages]

This chapter starts with a great quote about ocular rosacea: “The Rabbit-eye of Rosacea” – Gerd Plewig.

In this chapter we learn that patients with PPR appear to be more likely to suffer from Ocular Rosacea (OR) but that OR symptoms may accompany, precede or follow skin symptoms of rosacea. The duration and severity of OR does not appear to parallel  the type, duration or severity of rosacea skin symptoms. The reason that ocular symptoms are associated with a dermatological condition is unknown.

Studies of sufferers of OR have shown that the normal tear breakup time of at least 10 seconds is reduced by half. The tear breakup time is the time after a blink when the tear dries and in some spot a dry area occurs.

System therapy used for PPR is effective for the inflammatory lesions of OR. Most patients present with mild symptoms so simple measure are often enough.

The table of treatments includes artificial tears, lid and lash hygiene, topical and systemic antibiotics.

Chapter 8: General Considerations [12 pages]

This final chapter implores doctors to seek to understand the psychological aspects of rosacea, be proactive in asking about ocular symptoms, be open to differential diagnosis. There is also some advice of general skin care and cosmetic advice. Powell does answer an old chestnut about whether prescription topicals should be used before or after other skincare. Drugs have priority-they go on first ! we are told in italics.

As far as pregnant patients are concerned, Powell states that topical erythromycin is a possible permissible treatment; with the agreement of the obstetrician and in extreme cases. All other prescription topicals and systemics are not advised.

Doctors are advised to reassure patients that progression to rhinophyma is rare, that `cure’ along the lines of pneumonia is not the case with rosacea, but that it can be episodic.

In the final chapters Powell encourages doctors to reassure their patients and support them. Powell suggests patients will appreciate being directed to web sites of the AAD, the EADV and BAD. A typo sadly directs sufferers to the National Rosacea Society as nrs.com instead of rosacea.org and indeed the AAD web address is wrong as well.

The book ends with a detailed 6 page index.

The Price

For those not used to medical texts, an asking price of $80 USD may seem a little shocking. Indeed the full price at the publisher’s web site: informa healthcare is $100 USD. Bearing in mind that the book is targeted primarily at physicians and taking in to account the authority of the writer and material presented, the book is reasonably priced. Whether that value will translate into something you as a rosacea sufferer will want to pay for I can’t say.

After reading the book I can say that Powell’s book does represent excellent value for rosacea sufferers to use in partnership with their doctor, especially if their doctor is not overly familiar with treating rosacea. Many doctors will want solid research-backed recommendations before embarking on a particular treatment path. This is the sort of text that you can use to convince a sceptical doctor.

Want to get more of an idea of what the book looks like before purchasing it ? You can see several actual pages via 2 routes. Firstly you can Search Inside the Book at Amazon and secondly you can see many of the colour plates via the very generous Google Book Search listing for this book.

Along with large chunks of the book being available to preview, you ought to have enough information to decide whether to invest in the book yourself.

Conclusion

This book gets off to an excellent start because the author is a genuine rosacea expert who is widely recognised. Professor Powell’s book is the sort of text that will see the understanding of rosacea symptoms, diagnosis and treatment increase world wide.

This book is by and far the best book on rosacea that you can get your hands on.

You can purchase the book at Amazon.com: Rosacea Diagnosis and Management.

See Also: other Rosacea Book Reviews

In an ELLE Magazine December 2009 interview, New York Dermatologist Macrene Alexiades-Armenakas, MD, PhD tells us that she has rosacea.

A respected and published dermatologist, Dr. Alexiades-Armenakas says that she is one of the many people who cannot tolerate topical retinoids. Instead she prefers Finacea which she says is great for acne and rosacea, reduces oiliness and lightens brown spots, great for breakouts.

As an aside, given that she sufferers from rosacea, I wonder what sorts of results she sees herself from her own `high performance anti-aging cream’ known as dr.macrene 37 Extreme Actives. Sadly at $275 for 50ml I don’t think many will want to just try-see. If you are interested, here is the dizzying list of ingredients listed by DNA repair, cellular repair, anti-pigment, anti-red, anti-wrinkle, anti-oxidant, pro-collagen, barrier repair properties, to name a few.

Skin Care Made Simple: Tips for Wrinkles, Blemishes, and Redness

An NYC dermatologist shares her beauty secrets—and reveals a new superproduct.

Is Retin-A still the gold standard for anti-aging?
Retinoids have the longest track record, and they’re great for antiacne. But many people, like me, can’t tolerate them. Instead, I use the azelaic-acidbased prescription Finacea, which works on both rosacea and acne and also reduces oiliness, lightens brown spots, and is a great spot therapy for breakouts—it won’t make you red and flaky the next day.

Rosacea? You don’t look red.
Some doctors don’t agree with me on this, but rosacea is very common. By definition, if you stay red and you start to get broken capillaries and bumps, that’s rosacea. Hot weather, showers, drinks, and certain foods can cause flare-ups. Reduce these and you’ll see a change—fast.

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• Finacea (azelaic acid 15%) as a Rosacea Treatment
• Finacea is good for acne and hyper pigmentation as well
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The `oversized electric toothbrush’ is promoted as the path to expertly cleansed skin; not via wipes, creams and scrubs it seems.

Interestingly the Clarisonic has for a long time been promoted as a part of a cleansing regime for rosacea sufferers. Knowing just how sensitive the skin of rosacea sufferers can be, it was a brave marketing move for Clarisonic. So far it seems to have paid off, rosacea sufferers are mostly positive in their reviews. Even the price tag doesn’t seem to dull rosacea sufferers enthusiasm for this ultimate cleansing gadget.

From the Daily Mail article:

Get supersonic skin: From the makers of the most popular toothbrush, a face cleaner they claim is just as good

It is claimed that the Clarisonic Skin Care System can remove make-up six times more effectively than a manual cleanser, and is twice as effective when it comes to getting rid of grease, dirt and other assorted gunk that collects in our pores and on our skin. 

The toothbrush analogy is no coincidence. The product was developed by the team behind the Sonicare electric toothbrush, which as well as brushing teeth claims to be able to remove more plaque because of its ‘patented sonic technology’.

The article addresses my first question when I heard about the Clarisonic – exactly what is sonic about this product – does it use sound waves to cleanse the skin ?

Usually when scientists use the term sonic, they’re talking about soundwaves or things moving at the speed of sound. Here, according to David Hughes, Clarisonic’s director of international operations, it refers to the very fast oscillating movement of the bristles.

So there we have it, as suspected, the `sonic’ in Clarisonic, is mostly marketing speak.

The Clarisonic is being promoted as a way to make existing skincare regimes more effective. The idea being that properly cleaned skin is more receptive to moisturizers and indeed all skincare products. Whether you will get value from investing £150 in this product, only time can tell.

Overall, rosacea sufferers are impressed with the Clarisonic Skin Care System. You can see user reviews from fellow rosacea sufferers here: Clarisonic User Reviews

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A few newspapers have picked up this Question & Answer article where rosacea sufferers are encouraged to try Epsom salts (magnesium sulfate) or Milk of Magnesia on their skin.

One can imagine that a bath with Epsom salts would be relaxing, but I’m not sure that it is a reliable rosacea treatment per se. One possible reason for any benefits might be the presence of sulfur in the form of the sulfate.

Milk of magnesia is a mildly alkaline suspension of magnesium hydroxide and has been known to be used topically for canker sores. Other `folk’ usage of topical milk of magnesia is for acne, seborrheic dermatitis, and oily skin.

Might there be something real in using these kind of easily available products topically ? That would be a great result for those looking for cheap treatments !

People’s Pharmacy

By Joe and Teresa Graedon

COLUMNISTS

Q. I read about using milk of magnesia for treating acne. My skin condition is called rosacea. It is a painfully embarrassing problem, and no one seems to know what causes it or how to cure it. (W.C. Fields was the most famous rosacea victim, and people sometimes assume a red nose is a result of drinking too much.)

The pharmaceutical products my dermatologist prescribed failed to clear up my red bumps. So I tried magnesium sulfate in the form of a warm compress soaked in an Epsom-salts solution. This worked beautifully, but nobody is making the rounds telling dermatologists about it.

A. Magnesium sulfate (Epsom salts) is an old-fashioned multipurpose remedy that is sold as a laxative and muscle soak. Why it might work for rosacea is a mystery, but some readers have gotten relief from their redness and breakouts with topical milk of magnesia (magnesium hydroxide).

Here is one testimonial: “I’m 52, and my acne (actually rosacea) is related to menopausal hormone changes. Since my mid-40s, I’ve tried many different prescription and OTC treatments. I like milk of magnesia the best, and it’s by far the least expensive. I put MoM on my face at bedtime, and by morning my skin looks better.”

User Comments

From LoisAnne on Sun May 10, 2009, Anyone ever had this experience? My derm’s wife has rosacea and he laughs and says that she claims milk of magnesia works best for her! I told him he should check out this forum and see what people are doing for rosacea. (and I am also going to try Milk of Magnesia) Oh….on the face, not internally!

From Strive, 4th May 2008, Milk of Magnesia or magnesium hydroxide. Several years ago I read that this is a good mask for folks with acne, etc. I think the information might have been in the Paula Begoun book. Recently, I came across a bottle in my closet and have been experimenting with it overnight with some pretty good results. Maybe it’s just the absorption of oil that is helping, since I also have seb derm. Some people apparently keep it on briefly before washing it off. Has anyone else tried it?

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